Addiction Counselor Exam Review

By Dr. Dawn-Elise Snipes

Podcast review for persons preparing for the Addiction Counselor Certification Exam. To include: IC&RC, NCAC, MCAP, LADC, LADAC, CADC, LAC, CADAC exam reviews, exam preparation, addiction counselo... more

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Addiction Counselor Exam Review episodes:

December 16, 2017 200 -Creative Ways to Use Observation in Clinical Supervision
Creative Methods of Supervision
Creative ways to use video and audio tapes
Run the video in fast-forward to convey a heightened image of the counselors and clients body movements
On a video, turn down the audio to try to fill in what is being said on the basis of nonverbals
On a video, cover the counselor and observe the client to guess what the counselor is doing and vice versa.
On a video, focus on the counselor’s nonverbals
While reviewing the audio or video tape prior to supervision, the supervisor can do a voiceover, inserting questions for the supervisee onto the tape.
Review the tape and stop after a client statement. Ask the counselor to respond.
Co-facilitation and live Observation via closed-circuit video and one-way mirror supervision provide the ability to observe in real-time. They are time consuming, but less obtrusive than observing by sitting in the session or co-facilitating.
Case presentations are useful in groups and individual supervision. Should be built around problems and solution-oriented questions to be answered, and should move from client information to dynamics, prognosis, and treatment plan
Allow the supervisor to observe the counselor's actions, determine their impact on the client, assess the counselor's clinical reasoning process, and help the counselor improve treatment delivery
Role playing is an alternative to observing the clinician in an actual counseling session. It is ideal for practicing skills, and an opportunity to learn-by-doing in a safe environment where they can receive helpful feedback
Process recording provides a written account of everything that was said and done in session. It is only from supervisee point of view which can result in intentional and unintentional errors and omissions. To improve accuracy, it can be used with video to compare salient points.
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57min
December 16, 2017 201 -Overcoming Biases and Anxieties in Clinical Supervision
Providing Feedback, Addressing Anxiety and Overcoming Biases
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Review types of supervisory intervention
~ Identify types of biases and ways to overcome them
~ Identify types of anxieties and how to address them
Feedback and Intervention
~ Can be triaged into three levels:
~ Immediate intervention
~ Non-immediate intervention
~ Suggestions
~ Designed to enhance counselor competencies
~ Personal characteristics (self awareness, cultural competence)
~ Philosophical foundations
~ Communications (verbal and nonverbal)
~ Counseling skills
~ Adjunctive or administrative activity
~ Ethical behaviors
5 Types of Supervisory Intervention
~ Facilitative: Brings about discussion through nondirective questions
~ What might the next step be?
~ What other interventions might you have used?
~ What other explanations exist?
~ Confrontive: Addresses specific action or behavior and requires the counselor to answer a question about it
~ Why did you choose to pursue that avenue with the client?
~ What was your intent when you asked…
~ What is your timeline for preparing for the audit on January 25?
Cont…
~ Conceptual: Contributes new information and a different way of visualizing the case
~ Sally is a 27 year old female with a 7-month old child and presents with symptoms of depression
~ Depression?
~ Grief?
~ Hormone changes?
~ Stress and sleep deprivation?
~ Prescriptive: Directs the counselor to respond in a particular manner the next time a certain set of circumstances occurs
~ The next time the client begins blaming his wife for things…
~ The next time a client calls at the last minute to cancel…
Cont…
~ Catalytic: Moves the process along by asking provocative, or what if questions
~ What if the client were to gather baseline data for a week
~ What if you used the empty chair technique
~ What if the client were to try [x intervention] for 1 week
~ What if you held the client on point for X-topic
~ What if you helped the client reconceptualize the problem
~ In later practice this is often the feedback you get from colleagues when you ask for suggestions.
~ Good type of intervention for ethical issues
Feedback is
~ Supervisor's response to the data presented
~ Lack of data leads to ineffective feedback
~ Designed to:
~ Help the supervisor understand (get inside the head of) the supervisee
~ Bring about a positive change in the professional life of the counselor
~ Supportive, challenging and pragmatic
~ Not “It was a good session”
~ But “It was a good session. I liked how you… And …. I am wondering… If I had to give one suggestion or area to work on it would be….”
Effective Feedback
~ Is elicited rather than imposed
~ Supervisees should be seeking feedback
~ Is timely
~ Is communicated clearly, directly and with regard to specific issues
~ Is constructive and descriptive rather than critical or judgmental
~ When the client revealed his concern about his anger issues and you responded by saying, “well, once we get your anxiety under control, your anger will probably not be a problem” he seemed to shut down. I am wondering what you intended to communicate and what your rationale was
~ Not: “Your response to the client was totally inappropriate”
Cont…
~ Is directed toward changeable behavior
~ Stay on task
~ When clients… then you should …
~ Is not used as a disciplinary weapon
~ Constructive feedback is presented with positive feedback and/or recog
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1h 1min
December 13, 2017 199 -12 Things Supervisees Need to Learn in Clinical Supervision
12 Things Counselors Need to Learn and How Supervisors Can Facilitate Them
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Define 12 things counselors need to learn and discuss how supervisors can facilitate them
What Counselors Need to Learn
~ How to attend themselves to the client's feelings, establish rapport, to demonstrate caring, compassion, and empathy
~ How to find a collaborative, instead of combative, metaphor for treatment
~ How to develop and monitor the therapeutic alliance
~ How to marshal and enhance the potential for success through the use of
~ social support networks
~ community services
~ family and community resources
What Counselors Need to Learn
~ How to avoid falling into conventional wisdom that when treatment does not meet the desired outcome it is the client's fault
~ How to promote the client’s sense of personal control and empowerment
~ How to focus on the future and the client's ability to overcome the past
~ How to engage in brief therapy
What Counselors Need to Learn
~ How to establish the affective qualities essential to counseling before launching into diagnostics
~ How to adapt a relationship to different clients and their needs
~ The earlier change happens in treatment the more likely will be a positive outcome
~ How to identify not what the person needs, but what the person already has to work with
How Can Supervisors Help
~ Help is when the mind is present in the heart, when mind, body and spirit are integrated and when an individual is at peace with his mind body and spirit even if one of those elements is experiencing pain or suffering
Supervisors need to
~ Offer mystery, compassion, openness, and a simple presence instead of answers or being the expert
~ Learn contemplative listening which means
~ Being receptive to visual, auditory, kinesthetic and intuitive cues
~ Without an agenda
~ Without a compulsion to help
~ The most important phrases a supervisor can learn are “I don't know” and “I could be wrong”
Establishing Supervisory Relationships
~ Creating a contract involving mutually defined goals for both parties that allow for realistic accountability
~ Establishing a working relationship which includes laying groundwork of trust and respect
~ Assessing the counselor's clinical knowledge and skills and training needs using standardized instruments, transcripts and other methods of observation
~ Setting learning goals for the supervision and a form of supervision training plan
Goals of Supervision should be
~ Clearly stated, attainable, specific, measurable and observable
~ In writing (individual development plan, IDP) and agreed upon by the supervisor and supervisee
~ Contain specific action steps to bring about the outcome
~ Contain specific procedures to evaluate the outcome
Individual Development Plans
~ Include the following
~ Expectations for supervision including
~ the model of therapy
~ the number and types of patient to be seen
~ the number and duration of supervision sessions
~ the techniques and interventions to be used
~ The counselor's experience and readiness for the position including
~ the counselor's base of knowledge
~ his or her strengths and areas for growth
IDPs cont…
~ Procedures to be used to observe the counselor and practice
~ Procedures to be used to determine the counselor's reasoning, conceptualization, and decision-making skills
~ Procedures to be used to evaluate the counselor
~ Procedures to be used to intervene to help the counselor achieve supervision
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59min
December 10, 2017 198 -3 Stages of Supervisor and Supervisee Development
3 Stages of
Supervisor & Supervisee Development
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Review the stages of supervisor and supervisee development
~ Forming
~ Storming
~ Norming
Supervisor and Supervisee Development
The supervisor provides:
~ Nonjudgmental support
~ Uses a counseling, therapeutic approach addressing feelings thoughts and actions that may impede the supervisees professional performance
~ Is consultative with self-evaluation an exploration
~ Employs self supervision
Structures Underlying Development
~ Autonomy
~ Self and other awareness
~ Motivation
Development
~ Phase 1: Childhood: supervisor creates a safe place for supervisee to explore new techniques
~ Phase 2: Adolescence: alternating between exploration into new areas and retreating to the safety of home
~ Phase 3: Adulthood: mutual interdependence between supervisor and supervisee built on the foundation of basic universal values such as faith, hope, love, peace and respect
Developmental Stages
~ Counselor Level 1 “Forming”
~ Characterized by: high dependence on others, lack of self and other awareness, categorical thinking, high motivation and commitment to work
~ Plagued by feelings of anxiety and driven by the desire to do it right
~ And formulate clinical concepts on the basis of a single aspect of the client history
~ Practice by formulas such as “All clients in early recovery are __________”
Developmental Stages
~ Do not know how to formulate treatment plans
~ Cannot visualize and articulate therapeutic process from intake through intervention to termination
~ The supervisor environment is one that encourages autonomy of providing instruction support and modeling within a structured setting
~ The primary responsibility of supervisors for level 1 counselors is to protect client needs at all times while encouraging risk-taking by the counselor
~ To facilitate growth a supervisor should introduce the counselor to ambiguity and conflict
~ It is imperative that supervisors working with level 1 counselors take into account the supervisees learning style
Developmental Stages
~ Counselor Level 2 “Storming”
~ Realizing that cannot save the world, level two counselors become frustrated by their inability to solve difficult problems
~ Characterized by: Vacillating between autonomy and dependence, more self-aware of self and others, and consistently motivated
~ Although level 2 counselors have more skills and tools, they often do not know which tools to use with which client or why
~ Often vacillates between rejecting advice and assistance to desperately wanting to be comforted and protected
~ Level 2 counselors can empathize excessively with the client
~ Level 2 counselors progress in a cyclical rather than linear fashion regressing at times to earlier developmental issues
Developmental Stages
~ Counselor Level 3 “Norming”
~ Involves establishing one's own therapy model and normalizing that approach in a range of clinical situations
~ Characterized by: secure autonomy, awareness and acceptance of self and others, stable motivation
Developmental Stages
~ Supervisors: Level 1 “Forming”
~ Displays a mechanistic approach
~ Place a strong expert role
~ Depends on own supervisor
~ Is moderately to highly structured
~ Is invested in trainees adopting their own model
~ Has trouble with level 2 counselors
Developmental Stages
~ Supervisors: Level 2 “Storming”
~ Displays confusion, conflict issues
~ Sees super
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55min
December 09, 2017 197-5 Influences on the Supervisory Relationship
5 Main Influences in Clinical Supervision
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Explore the 5 Main Influences in Clinical Supervision
~ Philosophical foundation
~ Descriptive dimensions
~ The supervisor’s stage of development
~ The supervisee’s stage of development
~ Contextual factors including personal characteristics and setting/environment
Answer The Following Questions
~ How do I believe change occurs?
~ What are the crucial variables in training and supervision?
~ How do I measure success in supervision?
~ How do I contribute to that success?
~ What learning objectives do I have for supervision?
~ What techniques will I apply to measure/ensure learning objectives are met?
4 Factors That Affect Change
~ Extra therapeutic factors which are all factors related to client (supervisee) and not the actions of the therapist (supervisor)
~ Relationship factors, the single most significant issue in the therapy outcome, including caring, empathy, warmth, acceptance, mutual affirmation, and encouragement of risk taking
~ Placebo factors, such as hope and expectancy
~ Technique factors, account for only 15% of therapeutic change
Supervision Layers
~ Supervision will be impacted by 5 main influences:
~ Philosophical foundation
~ Descriptive dimensions
~ The supervisor’s stage of development
~ The supervisee’s stage of development
~ Contextual factors including personal characteristics and setting/environment
The Philosophical Layer
~ Basic beliefs about how we know what we know, what motivates people and how people change
~ How do you know what you know?
~ Where does mental illness come from?
~ What do you believe motivates people?
~ How does change occur?
Descriptive Layer: 10 Dimensions
~ Influential
~ Symbolic
~ Structural
~ Replicative
~ Counselor in treatment
~ Information gathering
~ Jurisdictional
~ Relationship
~ Strategy
Descriptive Layer cont…Influential
~ Determines whether the client and supervisee are influenced at an affective or cognitive level
~ What does this mean? (Thinking vs. Feeling)
~ What does it look like/sound like if they are being influenced at an affective level? Cognitive?
~ Are you typically influenced at an affective or cognitive level?
~ How do you keep supervisees motivated who are influenced at an affective level? Cognitive?
Descriptive Layer cont…Symbolic
~ Deals with whether latent or manifest content is addressed in counseling and supervision
~ What do you typically focus on—the seen or the unseen
~ When Sue gets frustrated with a client it manifests in lack of attention and irritability.
~ Do you help Sue learn to deal with her frustration and identify it as possibly a projection?
~ Do you teach Sue that she will get frustrated, but she has to learn to control how it manifests
~ Do you do something else?
Descriptive Layer cont…Structural
~ Describes whether therapy and supervision are spontaneous or planned
~ Discuss the benefits and drawbacks of daily, brief supervision
~ Discuss the benefits and drawbacks of weekly hour-long supervision
Descriptive Layer cont…Replicative
~ Refers to the extent to which the supervisor sees observed interactions as representations of isomorphic processes
~ What the client does in counseling, she does in “real life”
~ What the supervisee does in supervision represents what she does in session and in real life
Descriptive Layer cont…Counselor in Treatment
~ Has to do with whether training and personal therapy a
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58min
December 06, 2017 196 -10 Common Errors in Clinical Supervision
12 Common Errors in Supervision
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Error 1: Doing Harm to the Counselor
~ Error 2: Failing to Observe
~ Error 3: Passive Supervision
~ Error 4: Failure to Focus on Reciprocal Effects
~ Error 5: Failure to Ask Socratic Questions
~ Error 6: Terminating supervision upon licensure
~ Error 7: Undisciplined
~ Error 8: Failure to Individualize Training Plans
~ Error 9: Failure to Set Boundaries
~ Error 10: Not Practicing What You Preach
~ Error 11: Failure to provide adequate support
~ Error 12: Blurring the line between supervision and counseling
Reflection
~ Think about your supervisor.
~ What things did he/she do that you liked?
~ What do you wish he/she would have done?
~ What is one thing you will do differently as a supervisor?
The Purpose of Supervision
~ Bring about change in the knowledge, skills and behavior of another
~ Assist the counselor in self observing, self-correcting, self reinforcing, and self soothing
~ Ensure counselors remaining in the field are competent with regard to personal characteristics, philosophical foundations, communication abilities, counseling skills, administrative skills, and ethical behaviors
What Shapes Clinical Supervision
~ The theoretical model from which it is derived
~ Therapy
~ Education
~ How do these differ?
Traits of an Effective Supervisor
The 4 “A’s”
~ Available
~ Accessible
~ Able
~ Affable
Discussion: In what ways are you available, accessible, able and affable? How could you improve in any of these areas?
Errors 1 & 2: Doing Harm to the Counselor and Failing to Observe
~ 5 Main Components of Supervision
~ An experienced supervisor
~ Clients in clinical settings
~ A primary concern to “do no harm” with regard to both the client and supervisee
~ Monitoring counselor performance through observation
~ General
~ In session
~ The goal of changing the counselors behavior
~ How are you going to change a counselor’s behavior?
Error 3: Passive Supervision Fails to Develop Skills and Competencies
~ Supervision Through Leadership
~ Promote measurable development of skills and competencies
~ Raise the level of accountability and effectiveness in counseling services and programs
Leadership
Is based in a set of core values, and involves:
~ Teaching (Explaining, educating)
~ Mentoring (Practicing, showing)
~ Coaching (Cheerleading, encouraging, processing)
~ Emphasizes
~ Observing the client, counselor and organization (needs and interactions)
~ Doing no harm to client, counselor or organization
10 Principles for Leadership
• Take full responsibility for the decisions you make
• Put subordinates wellbeing above your own
• Give subordinates full credit for successes
• Take risks when they are in the best interest of the organization or the client
• Protect, support, defend subordinates to senior management
Leadership cont…
• Take a personal interest in the welfare of your staff
• Make decisions promptly
• Be a teacher
~ Learning Styles
~ Auditory, Kinesthetic, Visual
~ Active, Reflective
• Do not play favorites
• Do not give orders just to show who is boss
3 Roadblocks to Effective Evaluation
~ Lack of supervisor skills in evaluating supervisee performance (i.e. lack of understanding regarding setting measurable goals/objectives)
~ Confusion about the compatibility of evaluation and supervision
~ Anxiety evoking aspects of evaluation
Dis
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1h 2min
December 02, 2017 194 -10 Issues in the Diagnosis of Addictions and Eating Disorders
12 Errors in
Addiction and Eating Disorder Diagnosis
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Avoidant/Restrictive Food Intake Disorder
~ Anorexia
~ Bulimia
~ Binge Eating Disorder
~ Substance Use Disorder
~ Internet Gaming Disorder
~ Gambling Disorder
~ Sex Addiction and Gambling
Avoidant/Restrictive Food Intake Disorder (ARFID)
~ An Eating disturbance as manifested by persistent failure to meet appropriate nutritional and/or energy needs associated with 1+ of the following:
~ Significant loss of weight (or failure to achieve expected weight gain or faltering growth in children).
~ Significant nutritional deficiency
~ Dependence on enteral feeding or oral nutritional supplements
~ Marked interference with psychosocial functioning
~ Note: There is no body dysmorphia or fear of becoming fat
Avoidant/Restrictive Food Intake Disorder (ARFID)
~ The behavior is not better explained by lack of available food or by an associated culturally sanctioned practice.
~ The behavior does not occur exclusively during the course of
~ Anorexia nervosa
~ Bulimia nervosa
~ Body dysmorphic disorder
~ The eating disturbance is not attributed to a medical condition, or better explained by another mental health disorder.
~ Depression
~ Anxiety
~ Psychotic disorder
~ Chron’s Disease
Anorexia
~ Persistent restriction of energy intake leading to significantly low body weight (in context of what is minimally expected for physical health)
~ Either an intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain (even though significantly low weight).
~ Disturbance in the way one's body weight or shape is experienced
~ Undue influence of body shape and weight on self-evaluation
~ Persistent lack of recognition of the seriousness of the current low body weight.
Subtypes:
Restricting type
Binge-eating/purging type
Anorexia Differential and Confounds
~ Obsessive Compulsive tendencies common (R/O OCD)
~ Can occur in males (3.6% males have an ED)
~ Onset during puberty up to age 40
~ Depressive symptoms (primary or secondary)
~ Anemia
~ Low estrogen/testosterone
~ Reduced thyroid hormones
~ Potassium imbalances and arrhythmias
~ Common Co-Occurring Disorders
~ Depression
~ Anxiety
Binge Eating Disorder
~ Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
~ Eating, in a discrete period of time (e.g. within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances.
~ A sense of lack of control over eating during the episode (e.g. a feeling that one cannot stop eating or control what or how much one is eating).
Binge Eating Disorder
~ The binge eating episodes are associated with 3+ of the following:
~ Eating much more rapidly than normal
~ Eating until feeling uncomfortably full
~ Eating large amounts of food when not feeling physically hungry
~ Eating alone because of feeling embarrassed by how much one is eating
~ Feeling disgusted with oneself, depressed or very guilty afterward
Binge Eating Disorder
~ Marked distress regarding binge eating is present
~ Binge eating occurs, on average, at least once a week for three months
~ Binge eating not associated with the recurrent use of inappropriate compensatory behaviors
~ Note:
~ Binge Eating Disorder is less common but much more severe than overeating.
~ Bi
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1h
November 26, 2017 193 -8 Common Errors in the Diagnosis of Personality Disorders – Addiction Counselor Training Series
8 Errors in Effective Differential Diagnosis of Personality Disorders
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Review the criteria for
~ Paranoid
~ Schizoid
~ Schizotypal
~ Antisocial
~ Borderline
~ Histrionic
~ Narcissistic
~ Avoidant
~ Dependent
~ Obsessive Compulsive
~ Identify 8 common errors in diagnosis
Overview of Personality Disorder Diagnosis
~ Enduring pattern of inner experience and behavior that deviates markedly from cultural expectations in 2 or more areas
~ Cognition
~ Affectivity (range, intensity, lability, appropriateness)
~ Interpersonal functioning
~ Impulse control
~ Behavior is inflexible and pervasive
~ Behavior is stable and can be traced back to adolescence or early adulthood
~ Not better explained as a manifestation of consequence of another mental disorder or attributable to medical conditions or substances: (Mania, Addiction, Autism Spectrum, FASD)
~ Dx of a PD in someone under 18 requires a duration of at least 1 year
~ Adopted as well as biological children have similar chances of developing a PD indicating the influence of environment
Issue 1: Acculturation
~ Do not confuse with problems with acculturation
~ Take into account individual’s cultural background (ethnicity, country, urban/rural, high/low SES, religion)
~ Common intergenerational heritage
~ Shared values, beliefs, customs, behaviors, traditions, institutions, arts, folklore, and lifestyle.
~ Similar relationship and socialization patterns.
~ A common pattern or style of communication or language.
~ Geographic location of residence (e.g., country; community; urban, suburban, or rural location).
~ Patterns of dress and diet
Issue 1: Acculturation cont…
~ Cultural Issues
~ Minority groups, immigrants, individuals from different ethnic backgrounds and those with physical handicaps may display suspiciousness, guarded or defensive behaviors resulting from perceived neglect or indifference by the majority society
~ Some ethnic groups also display culturally related behaviors which should not be confused with
~ Paranoia
~ Avoidance
~ Dependence
Issue 2: Stereotyped Gender Roles
~ Do not misdiagnose based on stereotypical gender roles
~ Females: Borderline, histrionic, dependent
~ Males: Antisocial, narcissistic
~ Personality traits are only personality disorders when inflexible, maladaptive, persistent and cause functional impairment or subjective distress
Issue 3: Differentiate from Mood Disorders with Psychotic Features
~ Paranoid, schizoid and schizotypal must not have occurred exclusively within
~ Schizophrenia
~ Bipolar
~ Depressive disorders with psychotic features
Issue 4:Personality Changes from PTSD
~ Personality changes as the result of PTSD
~ Lack of interest in social relationships
~ Solitariness
~ Affect flattening/emotional numbing
~ Irritability
~ Lack of trust/paranoia
~ Avoidance of reminders of the event
Issue 5: Addictions
~ Differential diagnosis with addictive disorders (~47%)
~ More time spent getting, using, recovering from the substance than intended
~ Irritability, grudging during withdrawal
~ Paranoia or irritability while under the influence
~ Histrionic behaviors to manipulate getting the substance
~ Inability to stop or cut down
~ Dependence on dealers
~ Failure to meet important role obligations
~ Reduction in hobbies and important activities
~ Continued use despite 2 or more problems
~ Sensitive to perceived attacks on character
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1h
November 25, 2017 192 -10 Ways to Use Patient Placement Criteria to Improve Treatment – Addiction Counselor Training Series
Assessment and Patient Placement Tools
ASAM, FARS, LOCUS
Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs Counselor Education
Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery
Objectives
~ Differentiate between level of care guidelines and patient placement criteria
~ Learn about the Functional Assessment Rating Scale (Required in some states)
~ Learn about the ASAM (Required by most insurers)
~ Learn about the LOCUS (Often an alternate to the ASAM
~ Discuss why these tools are used and how they can benefit clinician and client
Patient Placement vs. Level of Care
~ Patient placement criteria suggests a treatment intensity level that meets the needs of the client
~ Level of Care Guidelines are defined by:
~ Insurance Providers
~ State Law (in some states)
Why Use Them
~ Provides a biopsychosocial approach to care management
~ Assists in defining potential strengths and obstacles to the recovery process as the client sees them
~ Helps guide treatment planning for
~ Biomedical Issues
~ Cognitive/Emotional/Behavioral Issues
~ Motivational Issues
~ Recovery Environment (including social supports)
~ Assists in providing Specific, Measurable, Achievable, Realistic, Time Limited Goals
FARS
~ Functional Assessment Rating Scale
~ Not a placement guideline per se
~ Helps more clearly define anchors for behavioral observations
FARS
FARS
FARS
ASAM– Assessment, Reassessment & Discharge
~ Physical
~ Acute Intoxication/Withdrawal Potential
~ Biomedical Conditions
~ Emotional/Cognitive
~ Emotional/Behavioral Conditions
~ Treatment Acceptance/Resistance (Readiness for change)
~ Behavioral
~ Relapse or Continued Use Potential
~ Social/Environmental
~ Recovery Environment
ASAM Levels
~ Level .05: Early Intervention (Relapse Prevention)
~ Level I: Outpatient (<9 hours per week)
~ Level II: IOP (9-19 hours per week)
~ Level II.5: PHP (20+ Hours per week)
~ Level 3: Residential
~ Level 4: Medically Managed Intensive Inpatient Services
LOCUS Dimensions
~ Risk of Harm
~ 1-Minimal
~ 2-Low
~ 3-Moderate
~ 4-Serious
~ 5-Extreme
~ Functional Status
~ 1-Minimal Impairment
~ 2-Mild Impairment
~ 3-Moderate Impairment
~ 4-Serious Impairment
~ 5-Severe Impairment
LOCUS Dimensions
~ Medical, Addictive and Psychiatric Comorbidity
~ 1-No Comorbidity
~ 2-Minor Comorbidity
~ 3-Moderate Comorbidity
~ 4-Major Comorbidity
~ 5-Severe Comorbidity
Recovery Environment
~ Level of Stress (A)
~ 1-Low
~ 2-Mild
~ 3-Moderate
~ 4-High
~ 5-Extremely Stressful
~ Level of Support (B)
~ 1-Highly supportive
~ 2-Supportive
~ 3-Limited Support
~ 4-Minimal Support
~ 5-No Support
LOCUS Dimensions
~ Treatment and Recovery History
~ 1-Fully Responsive
~ 2-Significant Response
~ 3-Moderate or Equivocal Response
~ 4-Poor Response (goals not achieved or gains not maintained)
~ 5-Negligible Response
LOCUS Dimensions
~ Engagement
~ 1-Optimal (Action)
~ 2-Positive (Preparation/Determination)
~ 3-Limited (Contemplation)
~ 4-Minimal (Contemplation)
~ 5-Unengaged (Precontemplation)
EXAMPLE Guidelines LOCUS Placement
~ Level 1 LOCUS Placement (up to 3h/week)
~ 1. Risk of Harm – clients with a rating of two or less
~ 2. Functional Status – clients should demonstrate ability to maintain a rating of two or less
~ 3. Co-morbidity – a rating of two or less
~ 4. Recovery Environment – a combined rating of no more than fou
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59min
November 22, 2017 191 -10 Common Errors in the Diagnosis of Mood Disorders and PTSD – Addiction Counselor Training Series
Mood Disorders and PTSD
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isn’t Brain Surgery
Objectives
~ Bipolar 1 & 2
~ Cyclothymic Disorder
~ Depressive Disorder
~ Persistent Depressive Disorder
~ Premenstrual Dysphoric Disorder
~ Circadian Rhythm Sleep Disorder
~ Generalized Anxiety
~ Social Anxiety
~ Panic Disorder
~ Agoraphobia
~ Acute Stress Disorder
~ PTSD
Manic
~ A. (Often ego-syntonic) A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy, lasting at least one week (or any duration if hospitalized).
~ Often the mood is irritable if due to the use of a substance or if the person’s wishes are denied
~ High mood liability is possible
~ In children, happiness, silliness inappropriate to context and developmental age
~ Depressive symptoms can occur during a manic episode lasting hours or a couple of days
Manic
~ B. During the period of mood disturbance and increased energy or activity, 3+ of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
~ 1) Inflated self-esteem (uncritical self-confidence) or grandiosity.
~ Despite no prior experience, person may undertake a grandiose task like writing a novel
~ Delusions of grandeur are possible
~ Children overestimate abilities and may think themselves better at things than they are
~ 2) Decreased need for sleep (eg, feels rested after only three hours of sleep).
Manic
~ 3) More talkative than usual or pressure to keep talking.
~ 4) Flight of ideas or subjective experience that thoughts are racing.
~ 5) Distractibility (ie, attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.
~ Heightened sense of smell hearing or vision may be reported
~ 6) Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (ie, purposeless non-goal-directed activity).
~ Marked increase in sociability including talking to strangers is common
~ Dress may become markedly more seductive or flambouyant
~ Person may become aggressive or hostile
Manic
~ 7) Excessive involvement in activities that have a high potential for painful consequences (eg, unrestrained buying sprees, sexual indiscretions, or foolish investments).
~ In children, developmentally inappropriate sexual preoccupations or taking on many tasks simultaneously
~ C. Causes marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
~ D. The episode is not attributable to the physiological effects of a substance (eg, a drug of abuse, a medication, other treatment) or to another medical condition.
~ Cocaine, amphetamines; Medications: steroids, L-Dopa, antidepressants, stimulants (ADHD, weight, decongestants); Light therapy, ECT, MS, Stroke, lupus, AIDS, encephalitis
Manic/Hypomania
~ Hypomania:
~ A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood increased activity or energy, lasting at least four consecutive days (4 days vs. 1 week)
~ The episode is not severe enough to cause marked impairment in social or occupational functioning
~ Do not confuse with euthymia —elevated mood that occurs for a couple days following remission of major depression
Major Depressive Disorder
~ A. 5 (or more) (2 or more for PDD) of the following symptoms have been present during the same 2-week period (2 years for PDD (1 in children) and represent a change
...more
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FAQs about Addiction Counselor Exam Review:

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More shows like Addiction Counselor Exam Review

My Favorite Murder with Karen Kilgariff and Georgia Hardstark

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